Medical instrument



W m7 T. M. O'DEA 3315,83

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Thomas M. O'Dea imymm fiwi A ORNEYS ww aw T. M. ODEA MEDICAL INSTRUMENT Apwili 5 13%3? 6 Sheets-Sheet 6 Filed July 6, 1965 R H O W M fi 90 W 0 M 5 1.. W W w m I .0: m9 mg 93 United States Patent Ofiice 3,315,861? Patented Apr. 25, 1967 3,315,863 MEDICAL INSTRUMENT Thomas M. ODea, Cheshire, onn., assignor to United States Surgical Corporation, Baltimore, Md., a corporation of Maryland Filed July 6, 1965, Ser. No. 469,650 16 Claims. (Cl. 227--19) The present invention relates to medical instruments of the type used for stitching hollow organs and the like and more particularly for stitching by applying and securing a series or charge of U-shaped staples.

Instruments of the type described have been developed which comprise a removable steel cartridge carrying a plurality of U-shaped staples in a predetermined relationship, which cartridge is adapted to be secured to a manually operated instrument body. The instrument normally comprises an operating rod at the forward end of which is arranged a plurality of thin fingers or 'bades which, when the instrument is assembled, coalign with the staple-holding slots in the cartridge. Operation of the instrument results in forcing the operating rod forward such that the fingers or blades penetrae the aligned slots and force the staples forward through the face of the cartridge. One such instrument is disclosed in United States Patent No. 3,080,564.

However, it has been found that the forward-extending blades or fingers are quite easily bent or deformed during the course of necessary handling, which results in a misalignment between the particular bent finger and its respective slot so that jamming of the instrument occurs. This jamming is quite detrimental because the surgeon does not know in advance that the instrument will jam, and the jamming takes place at a critical time of the surgery.

Anolher disadvantage is that when a cartridge of different slot configuration is desired or needed for the surgery, there is a necessity of replacing the operating rod with one that has a different finger or blade arrangement corresponding to the slot configuration of said cartridge. Since this correspondence must be selected by assistants or technicians, there is a greater chance for human error. Again, this inadvertent, erroneous selection results in jamming of the instrument at a critical point of the operation as described above.

Another disadvantage is that great care and time is required for cleaning and sterilizing the conventional operating rod because of the delicate blades mounted thereon.

Because the conventional cartridges are made of tinished steel, they cannot be economically discarded and resterilization and individual loading between uses is required.

It is now the practice in the art to ship the staples in their own package. Only when the staples arrive at their place of use are they loaded into the instrument cartridge. It is the present practice to use a tweezer or the like and manually insert each staple individually into a slot of the steel cartridge until it is completely loaded. As can be appreciated, this is a tedious and slow process and the chance for damaging the staples is great.

The present invention provides an apparatus which avoids all the disadvantages mentioned above.

Briefly stated, one embodiment of the present invention, in part, provides an inexpensive, disposable staplecarrying and ejection unit which is used for transporting the staples loaded therein during the factory assembling stage thereof; said unit comprises a plastic cartridge with a plurality of staple-storing slots and a drive member having a blade within each slot, also assembled therein prior to shipment. The unit remains in its sanitary package along with its associated color-coded anvil until use, at which time they are removed and assembled directly on the instrument.

The present invention also provides certain novel features regarding the cooperation of the unit and the instrument operating rod mechanism which enables the instrument to be used universally with many differently designed cartridges.

In another embodiment of the present invention, there is provided an elongated plastic cartridge of the type used in instruments for stapling gastro-intestinal anastomoses and the like. This embodiment is characterized by having one or more rows of spaced slots extending through the cartridge body and having individual pusher plates with cam operating buttons mounted on said slots behind the staples therein. Due to the camming action of the operating mechanism of the instrument, each pusher plate in succession is forced downward to effect the stapling action. After the entire charge of staples is spent, the instrument is withdrawn and the cartridge, with the pusher plates therein, is removed from the instrument and thrown away. Means are provided in each slot to prevent the escape of the pusher plates from the slots after the stapling operation is completed.

Other and further objects of the present invention will become apparent wiih the following detailed description when taken in view of the appended drawings in which:

IG. 1 is a side elevation of one embodiment of the present invention;

FIG. 2 is a rear elevation of the embodiment illustrated in FIG. 1;

FIG. 3 is a side elevation oer;

FIG. 4 is a front elevation of the staple magazine;

FIG. 5 is a front elevation of the driving member having the driving fingers thereon;

FIG. 6 is a sectional side elevation taken along line 6-6 of FIG. 4;

FIG. 7 is an exploded fragmentary view of one of the slots in the staple magazine;

FIG. 8 is a front elevation of present invention, wherein the arranged horizontally;

FIG. 9 is a front elevation of the drive member designed for use with the magazine illustrated in FIG. 8;

FIG. 10 is a sectional side elevation taken along line 10-10 of FIG. 8;

FIG. 11 is a top plan view of the embodiment shown in FIG. 8;

FIG. 12 illustrates the front jaw portion of the instrument (partially in section) with the magazine mounted thereon;

FIG. 13 is a top plan view partially in section of part of the instrument illustrated in FIG. 12;

FIG. 14 is a sectional top plan view taken along line 1'4-14 of FIG. 12; i

FIG. 15 is a side elevation of a staple magazine having yet another embodiment of the safety lock member;

FIG. '16 illustrates the staple magazine with yet a third embodiment of the safety lock member;

FIG. 17 is a sectional top plan view taken along line 17-17 of FIG. 16;

FIG. 18 is a fragmentary side elevation of yet another embodiment of the present invention and illustrates only the front portion of the instrument;

FIG. 19 is a partial sectional bottom view taken along line 19-19 of FIG. 18;

FIG. 20 is a top plan view of a fully loaded cartridge;

FIG. 21 is a fragmentary and sectional side view of the cartridge and instrument during operation;

FIG. 22 is a front sectional view taken along line 22- 22 of FIG. 21; and

of the removable lock memanother magazine of the staple seating slots are FIG. 23 is a perspective view of one of the pusher plates of the cartridge on FIG. 20.

Referring to the drawings in detail, there is illustrated in FIGS. 4, 5, 6 and 7 a first embodiment of the present invention which comprises a staple-carrying and ejection unit generally indicated as 10. Unit 10 comprises a staplecarrying cartridge 12 and associated stape drive member 14. Cartridge 12 is made of plastic such as Lexan, which is the registered trademark for a commercially available thermoplastic polycarbonate resin suitable as a molding or extrusion compound or any other material which is inexpensive but suitable for use as part of the organ clamp of the instrument. Cartridge 12 has a flat forward face 16 and bevelled vertical edges and is pro-' vided with a plurality of staggered slots 18 which extend through the cartridge body and which, in this embodiment, are arranged vertically in two parallel columns. As can be seen in FIG. 7, each slot has an enlarged central portion and two semicircular guide channels '19 oppositely positioned with regard to the long dimension of slot 18, wherein said guide channels .19 are shaped to receive each leg of staple 20 so as to positively guide the direction of movement of staple 20. The connecting leg of staple 20 extends across the enlarged portion of slot 18 and is spaced from the walls thereof. The top '22 of cartridge 12 is flat; however, a vertical groove 24 is defined on each side thereof; groove 24 and top 22 cooperate with the instrument in a manner described below. Two bores 26 also extend through cartridge 12 and function to seat U-shaped safety pin 42.

The staple drive member 14 is preferably made of metal and comprises a vertical rear body 28 and a plurality of pusher blades or fingers 30 extending from the front face thereof and arranged to be coaligned and partially inserted into each slot 18 of cartridge 12. The dimension of each finger 30 is such that it movably but snugly fits within its associated slot 18. Because of the enlarged portion of each slot 18, the thickness of each blade 30 is somewhat greater than the staple thickness so that the blades are more rugged and less easily deformed than would be the case if blades were only as thick as the staples. The length L of each finger (see FIG. 6) is sufficient to eject the staples beyond face 16 of the cartridge when pusher member l14 is operatively forced forward.

Referring now to FIGS. 1, 2 and 3, there is illustrated a fully loaded unit 10 prepared for shipment in a conventional sterile container (not shown). During manufacturing and assembly of unit 10, a three-pronged safety lock member 34 having a head with a finger opening 36 is assembled in locking engagement with the unit .10. Lock member 34 is preferably plastic and comprises three depending and spaced prongs 36, 38 and 40; the dimensions of these prongs and the spaces therebetween are such that the central prong 38 snugly fits between the rear body 28 and the rear face of cartridge 12 to prevent additional penetration of fingers 30 within cartridge 12. As can be seen in FIG. 1, the short, rearmost prong 36 overlaps rear body 28 while the forward prong engages the forward face 16. In this way, inadvertent relative movement between the drive member 14 and cartridge 12 is prevented during shipment of loaded unit. Thus, the sterilization of unit 10 need only be done once during manufacture and assembly thereof.

Since there are many cartridges with diiferent slot arrangements, each unit 10 is packaged along with its associated anvil, and to ensure a proper match, the unit and associated anvil are color coded. Anvil 49 has an elongated body with depressions 54 arranged on its front face which align with slots :18 when the instrument is ready for use. An elongated side groove serves to seat anvil 49 on the instrument, and any conventional means can be provided on anvil 49 to retain it thereon; for example, a leaf spring can be mounted on the back wall thereof which presses [against the forward leg of the C-clamp when the anvil is assembled.

Referring now to FIGS. 12, 13 and 14, there is illustrated the forward part of the stitching instrument which comprises jaw member 50 the forward leg of which has provided at its upper end two inwardly turned flanges 15 which receive the grooves of anvil 49. A U-shaped instrument body 55 is connected to the other leg of jaw 50 and has upstanding cars 61 mounted at the forward end thereof; each ear has a longitudinal groove 63 defined on its inner side for the purpose to be described below. Slidably nestling within U-shaped body 55 is a rectangular hollow tube 56 which serves to house and guide the operating rod 58 which is axially movable therein. There is mounted at the forward end of push rod 58 an elongated, vertically extending U-shaped pusher head 60, better seen in FIGS 12 and 14.

A carrier member 62 having spaced sidewalls 64 and 66 with enlarged forward flanges 68 is integrally connected to tube 56 and has its lower end shaped to ride on guide track 70 defined on the inside bottom of jaw member 50. Two parallel bores 72 extend in a forward direction within the upper ledge of carrier member 62 for the purpose of receiving the legs of U-shaped locking pin 42. In this regard it should be noted that bores 72 are axially aligned with bores 26 in cartridge 12 and that pin 42 is intended to extend longitudinally through both aligned bores.

Integral with the rear of carrier member 62 and the forward end of hollow tube 56 is an upstanding part 57 which has a guide pin 59 extending from the side thereof and slidably arranged in the respective grooves 63 of cars 60 and 61. Pins 59 ensure a guided forward and rearward motion of the carrier member 62 and prevent any relative vertical movement between carrier member 62 and jaw 50.

Assembly and operation of the present invent-ion will now be described. Prior to sterilization, cartridge 12 is machine loaded with a charge of staples 20 and staple drive member 14 is assembled the-rein along with safety lock member 34 in the manner as shown in FIG. 1. This entire assembly is then packaged along with sterilized anvil 49 in a conventional sanitary shipping container (not shown). Inadvertent relative movement between drive member 14 and cartridge 12 is prevented by the safety lock member 34 as described above. When the package arrives at the hospital it can be stored until it is to be used at which time the sanitary shipping package is opened and its contents placed in a sterile environment for immediate availability during the surgical operation. After the patient is fully prepared, the safety lock member 34 is manually withdrawn and discarded. Anvil 49 is mounted in place on leg 52. The corresponding color coded cartridge assembly 10 is then inserted in operating position at the forward end of the carrier member 62 by sliding unit 10 in the direction of arrows which are stamped thereon (see FIG. 12) with grooves 24 sliding over the enlarged flanges 68. The'vertical position of unit 10 is determined by the top of flange 68 against the overhang or top of groove 24. After unit 10 is thus seated, the legs of U-shaped pin 42 are inserted through aligned bores 72 and 26 so that unitary assembly 10 is aligned and locked in operating position. As seen in FIG. 14, when unit 10 is in operating position, the rear body 28 of drive member 14 is disposed in the space between the sidewalls 64 and 66 of carrier member 62 and is aligned with and spaced from the cavity of head 61).

During use, the hollow tube 56 is pushed forwardly so that the front face 16 of cartridge 12 can cooperate with the anvil 49 to clamp the organ in proper position. Next, the operating rod 58 is forced forwardly so that the U-shaped head 60 cups around the rear body 28 of drive member 14 and pushes this member forwardly which in turn drives each finger 30 forwardly within slots 18. In this way, each staple 20 is driven from its respective slot 18 forwardly into the organ and upon contacting its corresponding anvil depression 54, the staple legs are turned under into a permanently clamping shape. The staples 20 are moved forwardly until their rearmost parts clear the forward face 16 of cartridge 12. The mechanism of the instrument for moving operating rod 58 and hollow tube 56 in a forward direction can be of any suitable type, for example, that disclosed in United States Patent No. 3,080,564.

Next, the hollow tube 56 is drawn to the rear so that the clamping action between front face 16 and anvil 49 ceases relative to the stitched organ. After the instrument has been once used for a patient, the entire spent unit and anvil 49 are removed and discarded. The instrument is then ready to be recharged with another fully loaded unit 10 which can be easily and quickly assembled on carrier member 62 in the manner set forth above.

Referring now to FIGS. 15, 16 and 17, there are shown further embodiments of the safety lock member 34 of FIGURE 1. In FIG. 15, safety lock member 80 has a squared head and comprises an elongated, depending U- shaped pin 82 having its upstanding legs embedded in the plastic head portion of lock member 80. Forward leg 84 contacts the rear wall of cartridge 12 and rear leg 86 contacts the forward part of rear body 28 of drive member 14. As in the embodiment disclosed in FIG. 1, look member 80 has forward and rear depending prongs which engage the forward face of cartridge 12 and the rear wall of drive member 14, respectively. Operation of the embodiment shown in FIG. 15 is the same as described above.

Cartridge 12 and rear body 28 of the embodiment shown in FIGS. 16 and 17 each have an elongated vertical bore 88 and '90, substantially in the center thereof. The lock member 92 of the embodiment is also squared and has two spaced parallel depending wire pins 94 and 96 each with its upper end embedded in the head of lock member 92. Pins 94 and 96 are appropriately spaced so that they are received by bores 88 and 90 when lock member 92 is assembled with unit 10. Lock member 92 also has a forward prong which engages the front face of magazine 12 when the unit is assembled.

Operation of the embodiment illustrated in FIGS. 16 and 17 is apparent from the above description and it can be seen that pins 94 and 96 prevent inadvertent relative movement between the drive member 14 and cartridge 12. When it is time to assemble unit 10 on the stitching instrument, lock member 92 is withdrawn in the manner described about and unit 10 is ready for assembly.

Referring to FIGS. 8-l1, there is illustrated another embodiment of unitary assembly 1t) with like reference characters being used to identify corresponding parts. In

this embodiment, the slots 18 and corresponding fingers 31) are horizontally disposed and aligned in a single vertical column. Operation of this embodiment and its cooperation with the instrument is the same as that described above, and the lock member used with an embodiment of this type would be that illustrated in FIGS. 16 and 17; the appropriate vertical bores in rear body 28 and cartridge 12 are shown in FIGURE 17.

It should be understood that any desired number or arrangement of slots can be provided in cartridge 12 without departing from the spirit of the present invention and that the particular embodiments disclosed are only by way of example. However, it is within the purview of the present invention to provide an operating rod which can be used with any or all the cartridge embodiments notwithstanding their differing slot arrangements.

Referring now to FIGS. 18-23, there is illustrated another embodiment of the present invention which comprises a staple carrying and ejection unit generally indicated as 100. Unit 160 comprises an elongated, U- shaped cartridge 102 which is provided with a plurality of parallel spaced slots 104 extending through each leg thereof. Cartridge 102 is made of a plastic such as Lexan and the like and is provided with an enlarged nose 196 which facilitates easy insertion of the instrument into the hollow organ. Each slot 104 comprises a wide stapleseating groove 1118, which is dimensioned to receive and guide a surgical staple 110, an intermediate width groove 112, and a narrow width groove 114. The grooves communicate with each other and have vertically extending sidewalls which are flat, with the exception of two inwardly facing stops 116 located at the bottoms of the sidewalls of narrow groove 114.

A staple drive member 118 is provided near the top of each slot 104 behind the staple seated therein. Each drive member has a square pusher plate 120 with a cylindrical intermediate button 122 symmetrically mounted on one face thereof and a smaller cam button 124 coaxially mounted thereon. As seen in the figures, the thickness and width of pusher plate 120 is such that its back face lies flush against the outermost wall of slot 1% and a portion of its front face lies in sliding contact with the forward walls of intermediate groove 112. In this way, a pusher plate is positively guided during its downward movement by slot 104, and the bottom of pusher plate 120 engages the connecting leg of staple 110 to force said staple downward during the operation. of the instrument. Intermediate button 122 cooperates with the sidewalls of narrow groove 114 and abuts against stops 116 when drive member 118 reaches its lowermost position. Moreover, stops 116 prevent the escape of the staple drive member 118 from cartridge 1&2. As better seen in FIG.

22, the cam buttons 124 face inward and extend partially within the center space 126 of U-shaped cartridge 102. Cam buttons 124 are also spaced from top wall 193 of cartridge 102.

Referring to FIGS. 18 and 19, there is illustrated a med calinstrument generally indicated as 128 which comprises a lower elongated jaw clamp 130 tapered toward its forward end and having two upstanding outer walls 134 spaced from each other to define an elongated groove 132. The top surface of each wall134 provides a clamping anvil surface with depressions 161 and has a plurality of upstanding and longitudinally spaced teeth 160 which aid in securing the clamped tissue.

Instrument 128 alsocomprises an elongated forward extending, U-shaped channel member 136 which has two fingers 138 mounted at the lower ends of its opposite legs. The channel member 136 is dimensioned to slidably receive on its inner surface the entire unit 164 which when fully seated, receives fingers 138 in similarly recesses 140 located at the bottom rear of nose 106. Because the top of nose 106 is slightly higher than the top 103 of cartridge 162, so that the unit 160 and channel member 136, when assembled, provided a smooth and continuous top surface so that snagging is avoided as the instrument is inserted or withdrawn from the organ. See FIG. 18. Cartridge 100 also has a rearward extending ledge which fits in channel 147 on the instrument. Unit 164) is held fast on the instrument by locking pin 142, which passes through openings 144 in channel member 136 and into the recesses 146 of cartridge top 1112.

Instrument 128 also has an elongated axially movable operating rod 148 positioned in thehandle thereof and axially to the rear of channel member 136. An inclined plane 150 is provided at the forward end of operating rod 148 and has a camming surface 152 at the bottom thereof. Depending blade 154 has a forward cutting edge and is mounted beneath operating rod 148 slightly to the rear of the camming surface 152. As can be seen in the bottom view of FIG. 19, the operating rod 148, camming surface 152 and blade 154 are aligned with the center space 126 of cartridge 102.

The remaining structure of the instrument 128 including the handle and operating mechanisms can be of any conventional type, such as that disclosed in United States Patent No. 3,079,606. Operation of the instrument asiembling, rotating and locking mechanisms for the renaining part of instrument 128 can function in the same nanner as disclosed in said United States patent, and such itructure and operation does not form a part of the pres- :nt invention.

The operation of this'embodiment of the present invenliOn will now be described. During the manufacturing and assembly of unit 100, all assembled parts thereof are sterilized and packaged in appropriate sanitary containers, which are used for shipping unit 100 from the place of manufacturing to the hospital. Such package can be stored for any length of time at the hospital until required for use; at which time, the package is opened and unit 160 removed and subsequently assembled on channel member 136 of the instrument. Locking pin 142 is inserted through openings 144 into recesses 146 to lock unit 160 in operating position on the instrument.

As the upper jaw is inserted within the hollow organ, nose 1% presents a rounded, smooth surface so that snagging is prevented. After the upper jaw of the instrument is in place, the lower jaw 130 is moved upward so that the anvil surface thereon clamps the tissue in cooperation with the lower surfaces of cartridge 102. As seen in FIG. 21, the two layers of tissue are thus clamped in overlapping relation. When the surgeon is satisfied that the tissue is properly clamped, the operating rod 148 is forced forward by any conventional means, for example, that disclosed in United States Patent No. 3,079,606. As the camming surface 152 of the inclined plane 150 engages each successive cam button 124, the latter is forced downward due to the relative movement between said surface and said button. In this manner, each pusher plate 120 is forced downward in its respective slot 104 whereby the lower end of plate 120 forces its associated staple 110 downward through groove 108. After the legs of staple 110 pierce the layers of tissue, they contact the depressions on the anvil surface of walls 134; the legs are turned inward and under as pusher plate 124) continues to lower in response to the moving camming surface 152. Blade 154 immediately follows camming surface 152 during its forward travel and severs the prior stapled layers of tissue on a line exactly between the parallel rows of staples.

After all staples are securely clamped, lower jaw 13%) is disengaged, and the instrument is withdrawn toward the rear. Stop members 116 in slots 1194 prevent any of the pusher members from accidentally falling from the slots.

After the instrument has been removed from the organ, unit 100 is removed and disposed of. At this time, the instrument is prepared to receive another fully loaded unit 106.

It should be understood that other and further modifications could be made to the herein disclosed embodiments without departing from the spirit and scope of the present invention.

What is claimed is:

1. A disposable unitary staple cartridge assembly, especially for use in a surgical stapling device, compris- "ing: a cartridge member, a plurality of slots extending through said member adapted to hold a staple therein having a back end located intermediate the ends of the slot, a staple drive member including a plurality of finger elements, said drive member being aligned relative to said cartridge member by means of said fingers extending to a substantial extent into respective ones of said slots and into abutting relation with the back end of each staple, mounting means on said cartridge member for mounting said assembly as a unit on a stapling device.

2. The cartridge assembly as set forth in claim 1, further comprising a safety lock member comprising depending means, said depending means slidably engaging said cartridge and drive member forpreventing inadvertent relative movement between said drive member and said cartridge.

3. The cartridge assembly of claim 2, wherein said safety lock member comprises a plastic head with a finger opening provided therein and said depending means comprises a forward prong, an intermediate prong and a rear prong which, when said safety lock member is assembled on said assembly contacts the back wall of said drive member, said intermediate prong fits between said drive member and the back wall of said cartridge, and said forward prong engages the front face of said cartridge.

4. The cartridge assembly of claim 2, wherein said safety lock member comprises a head and said depending means comprises a first and second parallel spaced pair of pins having their upper ends embedded in said head, said drive member and said cartridge each being provided with a vertical bore extending partially therethrough and adapted to receive said pins when said safety lock member is assembled thereon.

5. The cartridge assembly of claim 2, wherein said safety lock member comprises a head having an elongated U-shaped pin the legs of which are embedded in said head, whereby said elongated U-shaped pin extends between said drive member and the back wall of said cartridge when said safety lock is assembled thereon.

6. The unitary assembly of claim 1, said drive member including a back planar portion, said finger elements extending perpendicularly to said back portion, said back portion defining the extreme rearward extent of said assembly.

7. A staple-carrying and ejection unit as set forth in claim 1 wherein the forward face of the cartridge has outward and rearward extending bevelled side edges.

8. A medical instrument for stapling organs and the like comprising a C-shaped jaw having an upstanding forward leg, an elongated instrument body connected to the rear of said jaw, a movable carrier member positioned within the mouth of said jaw and movable toward and away from said forward leg, an upstanding pusher head positioned within said carrier member and relatively movable thereto in a forward and rearward direction, an elongated operating rod connected to said pusher head and extending rearward through said elongated instrument body, a removable disposable staple carrying and ejection unitary assembly comprising a staple-holding cartridge provided with a plurality of slots extending through said cartridge, each slot being adapted to hold a surgical staple therein, said assembly further comprising a drive member having an elongated rear body positioned behind and spaced from the rear wall of said cartridge and having a plurality of drive blades extending from said rear body and each penetrating a respective one of said slots, said assembly being removably mounted on the forward end of said carrier member, an anvil provided with a plurality of depressions correspondingly arranged in association with the slot arrangement of said cartridge, means for mounting said anvil on the rear face of said forward leg such that said depressions face said carrier member, whereby the organ to be stitched may be clamped between the forward face of said cartridge and said anvil when said carrier member is moved forward, after which said operating rod is forced forward and said pusher head engages said rear body of said drive member, forcing the same forward to effect the ejection of each said staple in said cartridge.

9. A staple-carrying cartridge for use with a medical stitching instrument and the like having a front face, a plurality of staple-seating slots extending through the cartridge and communicating with said front face, each side of said slot defining the width thereof having a groove therein to receive one leg of a staple, and the sides of said slot defining the thickness thereof being spaced a distance greater than the thickness of a staple adapted to be re ceived therein.

10. A staple-carrying and ejection unit for use with a medical instrument for stapling organs and the like cornprising a removable disposable unitary cartridge assembly including an elongated U-shaped staple-holding cartridge and a staple drive member, said cartridge comprising mounting means for mounting said assembly on the instrument and provided with a plurality of slots extending therethrough, each slot being adapted to hold a surgical staple therein, said cartridge having a face adapted to contact the organ to be stapled, said drive member being positionable at least partially within each slot with a respective staple also positioned therein and said member being movable relative to said cartridge, said staple drive member being so positioned in said cartridge prior to the mounting of the assembly on the instrument, said drive member comprising a plurality of pusher plates each mounted within one of said slots behind a surgical staple therein, and cam means mounted on each said pusher plate and extending toward the center plane of said cartridge.

11. A staple-carrying and ejection unit as set forth in claim 10, wherein each slot comprises a staple-seating groove and a communicating narrower but thicker channel in which each said pusher plate is movably positioned whereby the thickness of said pusher plate is greater than the thickness of said staple and wherein said cam means comprises a cam button mounted on said pusher plate.

12. A staple-carrying and ejection unit as set forth in claim 11, wherein said slot further comprises an innermost mouth having vertical walls and being narrower than said channel, said mouth having inwardly facing stop means at the bottom thereof, and a cylindrical stop button mounted between said pusher plate and said cam button having a dimension such that its downward movement is arrested by said stop means to prevent the escape of said pusher plate from said slot.

13. A staple-carrying and ejection unit as set forth in claim 12, wherein said cartridge is made of plastic and comprises an enlarged smooth-surfaced nose which, in cooperation with said U-shaped member, presents smooth surfaces to prevent snagging when said instrument is being inserted or withdrawn from the organ.

14. A medical instrument comprising an elongated U-shaped member, handle means connected to one end of said U-shaped member, a removable disposable unitary cartridge assembly including an elongated U-shaped cartridge and a pusher plate, said assembly being removably mounted to said U-shaped member, a plurality of parallel slots arranged in each leg of said U-shaped cartridge and communicating with the bottom surface of said legs and the center space of said U-shaped cartridge, each said slot being adapted to hold a surgical staple near the bottom thereof and a pusher plate slidably mounted in each said slot and adapted to force a staple in a downward. direction when said pusher plate is moved downward, cam means mounted on each said pusher plate and extending into the center space of said U-shaped cartridge but being spaced from the cam means extending into said space from the pusher plate in the opposite leg of said cartridge, said instrument further comprising an elongated clamping jaw having at least one anvil surface thereon which cooperates with the bottom surfaces of the legs of said U-shaped cartridge to clamp the tissue to be stapled, means mounted on said anvil surface for turning the legs of the driven staples inward upon contacting thereof, said instrument further comprising an operating rod axially movable through said U-shaped cartridge and having a cam member mounted on the forward end thereof, said cam member successively engaging each of said cam means and forcing the latter downward in response to the axial movement of said operating rod through the U-shaped cartridge, and means for retaining said U-shaped cartridge on said U-shaped member.

15. A medical stitching instrument comprising a cartridge assembly support, a removable unitary cartridge assembly comprising a plastic cartridge removably mounted on said support and having a face adapted to engage an organ and the like, a plurality of slots arranged in said cartridge and communicating with said face, each said slot being adapted to hold a surgical staple therein, a pusher positionable in each said slot behind the staple therein prior to the assembly of said cartridge on said support, said instrument further comprising an anvil relatively movable with respect to said face and cooperating therewith to clamp the organ, said anvil having means thereon aligned with each said slot for contacting said staple after the latter has been ejected from said slot and means for moving said pusher in said slots to eject said staples.

16. A staple cartridge assembly, especially for use in a surgical stapling device, comprising: an elongate cartridge member having a longitudinal axis, a plurality of slots extending through said member perpendicularly to said axis, said slots being arranged in series along the direction of said axis, each of said slots being adapted to house a staple, a staple drive member including a plurality of finger elements each aligned. with a respective one of said slots, said drive member being reciprocable perpendicularly to said longitudinal axis with said finger elements extending through said slots, respective spacer means on said cartridge and drive members, a removable spacer member engageable and disengageable with said spacer means through movement in a. direction parallel to said longitudinal axis, said spacer member when engaged with said spacer means holding said cartridge and drive members in a fixed position relative to each other.

References Cited by the Examiner UNITED STATES PATENTS 2,632,889 3/1953 Beecroft 227- 3,017,637 1/ 1962 Sampson. 3,079,606 3/1963 Bobrov et a1. 3,080,564 3/1963 Strekopitov et al. 3,144,654 8/1964 Mallins et al. 227-l9 3,191,842 6/1965 Fischer et a1.

FOREIGN PATENTS 1,237,035 6/ 1960 France.

618,922 9/1935 Germany.

GRANVILLE Y. CUSTER, JR., Primary Examiner. 

8. A MEDICAL INSTRUMENT FOR STAPLING ORGANS AND THE LIKE COMPRISING A C-SHAPED JAW HAVING AN UPSTANDING FORWARD LEG, AN ELONGATED INSTRUMENT BODY CONNECTED TO THE REAR OF SAID JAW, A MOVABLE CARRIER MEMBER POSITIONED WITHIN THE MOUTH OF SAID JAW AND MOVABLE TOWARD AND AWAY FROM SAID FORWARD LEG, AN UPSTANDING PUSHER HEAD POSITIONED WITHIN SAID CARRIER MEMBER AND RELATIVELY MOVABLE THERETO IN A FORWARD AND REARWARD DIRECTION, AN ELONGATED OPERATING ROD CONNECTED TO SAID PUSHER HEAD AND EXTENDING REARWARD THROUGH SAID ELONGATED INSTRUMENT BODY, A REMOVABLE DISPOSABLE STAPLE CARRYING AND EJECTION UNITARY ASSEMBLY COMPRISING A STAPLE-HOLDING CARTRIDGE PROVIDED WITH A PLURALITY OF SLOTS EXTENDING THROUGH SAID CARTRIDGE, EACH SLOT BEING ADAPTED TO HOLD A SURGICAL STAPLE THEREIN, SAID ASSEMBLY FURTHER COMPRISING A DRIVE MEMBER HAVING AN ELONGATED REAR BODY POSITIONED BEHIND AND SPACED FROM THE REAR WALL OF SAID CARTRIDGE AND HAVING A PLURALITY OF DRIVE BLADES EXTENDING FROM SAID REAR BODY AND EACH PENETRATING A RESPECTIVE ONE OF SAID SLOTS, SAID ASSEMBLY BEING REMOVABLY MOUNTED ON THE FORWARD END OF SAID CARRIER MEMBER, AN ANVIL PROVIDED WITH A PLURALITY OF DEPRESSIONS CORRESPONDINGLY ARRANGED IN ASSOCIATION WITH THE SLOT ARRANGEMENT OF SAID CARTRIDGE, MEANS FOR MOUNTING SAID ANVIL ON THE REAR FACE OF SAID FORWARD LEG SUCH THAT SAID DEPRESSIONS FACE SAID CARRIER MEMBER, WHEREBY THE ORGAN TO BE STITCHED MAY BE CLAMPED BETWEEN THE FORWARD FACE OF SAID CARTRIDGE AND SAID ANVIL WHEN SAID CARRIER MEMBER IS MOVED FORWARD, AFTER WHICH SAID OPERATING ROD IS FORCED FORWARD AND SAID PUSHER HEAD ENGAGES SAID REAR BODY OF SAID DRIVE MEMBER, FORCING THE SAME FORWARD TO EFFECT THE EJECTION OF EACH SAID STAPLE IN SAID CARTRIDGE. 